Transplant Trial Watch

Treating Posttransplant Anemia With Erythropoietin Improves Quality of Life but Does Not Affect Progression of Chronic Kidney Disease

Pile, T., et al

Experimental and Clinical Transplantation (2020) 1: 27-33


Aims
The study examined whether treatment of anaemia in adult kidney transplant recipients reduced graft dysfunction and proteinuria.

Interventions
Subcutaneous epoetin beta to achieve a target hemoglobin level of 11.5 to 13.5 g/dL, versus no treatment (control group).

Participants
Fifty-five, adult kidney transplant recipients who were at least 3 months posttransplant.

Outcomes
Primary outcomes were graft function measured by change of kidney graft function using estimation of glomerular filtration rate (eGFR) and changes in proteinuria measured by protein-to-creatinine ratio. Secondary endpoints included blood pressure, quality of life and changes in left ventricular mass index.

Follow-up
Median follow-up was 23.34 months (IQR, 13.24-26.45) in the control group and 23.12 months (IQR, 17.

CET Conclusions
This single centre, open-label, RCT investigated whether anaemia treatment reduced graft dysfunction and proteinuria in adult kidney transplant recipients. Patients who were at least 3 months posttransplant were randomised according to a computer-generated sequence to subcutaneous epoetin beta to achieve a target haemoglobin level of 11.5-13.5 g/dL or no treatment. Fifty-five patients were randomised of whom all completed the study in the epoetin beta group whereas 5 patients withdrew from the control group. The median follow up was 23 months. At the end of the follow up there was no difference in the rate of eGFR decline or proteinuria between groups. There were no differences for the secondary outcomes change in blood pressure and left ventricular mass index but the vitality domain of the quality of life scale showed significantly different improvements. Overall, the treatment is safe and well-tolerated by patients but epoetin beta did not reduce the decline in graft function.

Jadad score
3

Data analysis
Per protocol analysis

Allocation concealment
No

Trial registration
ISRCTN41687085

Funding source
Industry funded